Application of paravertebral nerve block to thoracotomy

Objective: Paravertebral blockade （PVB） combined with general anesthesia for thoracotomy was introduced in this article.Methods: 20 patients, aged 39~76 years, ASA grade Ⅰ~Ⅱ,were scheduled for selected thoracic surgical operations. They were randomly divided into two groups: group A （general anesthesia only;n=19） and group B （general anesthesia plus PVB;n=10）. The patients in group A were maintained by inhaled sevoflurane and intravenous fentanyl, while those in group B were maintained by inhaled sevoflurane plus PVB. The inhaled and exhaled concentrations of sevoflurane were compared between group A and B; And the awake time from anesthesia, the time for extubation, the time for recovery of postoperative pain, as well as the hemodynamics during operation were compared in this two groups. Results: The inhaled concentration of sevoflurane during anesthetic maintenance period declined 62.8% （P＜0.01） in group B than that in group A; the hemodynamic parameters were more stable; the awake time from anesthesia and the time for extubation after operation were shorter in group B （allP＜0.01）; and the patients in group B felt a wound pain at 6~10 hours after operation, but those in group A complained pain immediatedly after extubation. Conclusion: PVB combined with general anesthesia applied to thoracotomy may reduce the required dose of general anesthetic or analgesic, thus reduce the side effects of anesthetics, faciliate maintaining the stability of hemodynamics during operation, make the patients more quickly awake from anesthesia, and delay postoperative wound pain.